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HomeMy WebLinkAbout38050-Z..a;,. M1~~S~yp~~ o~ _.. _. Towu of Southold Annex ;~ 5~ P.O. Box 1179 54375 Main Road ~ '7r ~ i! i~ Southold, New York 11971 4 ~, ,'- a ~:::rrn,~ CERTIFICATE OF OCCUPANCY No: 36464 Date: THIS CERTIFIES that the buildiug DECK Location of Property: 1055 Stanley Rd, Mattituck, 8/27/2013 8/27/2013 SCTM #: 473889 Sec/Block/Lot: 106.-8-54.4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 5/9/2013 pursuant to which Building Permit No. 38050 dated 5/23/2013 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: "as built" deck addition to an existing one family dwelline as applied for The certificate is issued to Phillips, Peter (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED __ - Autho Sign ture J ~F~~.,. TOWN OF SOUTHOLD , ' 4 BUILDING DEPARTMENT ~;~ ~~ TOWN CLERK'S OFFICE ?'a ~ `' . ' SOUTHOLD, NY ~to~ ,~ ,~ao*,< ' BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 38050 Date: 5/23/2013 Permission is hereby granted to: Phillips, Peter 6 North Dr Malba, NY 11357 To: construct a Deck Addition "as built" as applied for At premises located at: 1055 Stanley Rd, Mattituck SCTM #_473889 Sec/Block/Lot # 106.-8-54.4 Pursuant to application dated 5/9/2013 and approved by the Building Inspector. _____ To expire on 11/22/2014. Fees: AS BUILT -SINGLE FAMILY ADDITION/ALTERATION $912.00 CO -ADDITION TO DWELLING $50.00 Total: $962.00 '~~~~~ ___-- Building Inspector form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICp.TE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Deparhnent with the following. A. For new bu'rldiRg ar new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or .topographic features. 2. Final Approval from Health Dept. of water supply and sewerege-disposal (S-9 form). 3. Approval of electriea! iristatiation from Board of Fire Underwriters. 4. Sw.om statement from plumber certifying thaE the solder used in system contains less fhan 2/10 of 1 % lead. . 5. Commercial building, iadustria! building, mtiltipfe residences and similar buildings and installations, a certificate of Code Compliahce'from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 4, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey o€ property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent [o inspect signed by the applicant. If a Certificate of Occupancy is denied, [he Building Inspector shall state the reasons therefor in writing to the applicant_ C. Fees 1. Certificate of Occupancy -New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $'S0-00, Businesses $50.06. 2. Certifreate of Occupancy on Preexisting Building - $100.00 3. Copy of Cerdfica[e of.Occupancy - $:25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy -Residential $ l 5.00, Commercial $I 5.00 ' / Date. MLL~ 9~ ~'~ ~ 3 New Construction: y Ofd or Pre-existing Building: (check one) - '` Location of PropeRy: ~ ~+.~ ~Jq L~. cam! tit hQr ~CaT+ I ~yG~G House No. / Street Hamlet Owner or Owners ofProperty: ~¢-~Y Pti/ ~ ~ 1 ~5 Suffolk County Tax Map No 1/0-00,/Section / O~j Block ~ Lot ~ ~ " a = y Subdivision SV~ S¢T 1~nOIIS Filed Map. Lot Permit No. Date of Permit. Applicant: Health Rapt- Approval- Underwriters Approval: ?tanning Board Approval: 2equest for: Temporary Certificate _ _ Final Certificate: __` (check one) App/G~cai/ti/S~igna[ure ~. TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 [] [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ] ELECTRI~L (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: ~ / ~-+~-c-Li ~- NSPECTION FOUNDA N 1ST [ ]ROUGH PLBG. [ ] F DATION 2ND [ ]INSULATION [ FRAMING /STRAPPING FINAL DATE J ~ ~ ~ INSPECTOR /~'J r ,/ ~~ ~~ ~- ~yoe souryo ,~0 6 f ~~~.~ TOWN OF SOUTNOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING /STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH P G. [ ] IN ATION [ FINAL [ J FIRE SAFETY INSPECTION ~~ ~ INSPECTOR [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) GELD ON REPORT DATE COMMENTS / ~ ~ BOUNDATION (1ST) ~% ~1 -; a~ . ~ FOUNDATION (ZND) [ , ~ ~ O ~~ m ~ ROUGH FRAn'ItNG & ~ i PLUMBIIVG t~ -r- t~7 INSULATION PER N Y y . . STATE ENERGY CODE ~ d r r--, ~- ~- FINAL <, ADDITIONAL COMMENTS 3- ® _ ' ~o ~~ z m "~ ,~ ' ~~ v-~ ~ ~g f ~ y r L `- y~ . ~V 'i TOWN OF SOUTHOLD BU[LDII*iG DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined~20~ Approved ~ ~32d~ Disapproved a/c Board of Health 4 sets of Building Plans Plannine Board approval Survey__ Check _. Septic Form N.Y.S. D.E.C. Trustees C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: V'Y4SS P~yS~ Z,~ ~ , Phone: (D,'3~ ~/~fri -tl»7 Expiration ~ , 20~ r ~~~]C~ DC~.C: I~l ~ ~~ Building Inspector I D APPLICATION FOR BUILDING PERMIT {lAY - ! 20q ~ I Date Muy 9 . zU / 3 I>~~ nr, oE~t. INSTRUCTIONS n~~;;;, ;;r so~~moto a. This application MUST be completely tilled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be coma enced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pact for any purpose what so ever to til the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not con menced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations of ecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HF,REBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constructioo-of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~~ ; G/~ss~lys~Th~. (Signature of applic nt or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, >eneral contractor, electrician, plumber or builder ~'2h.2ra Name of owner of premises If (Name ar Builders License 4 Do you have or need the following, before applying? PERMIT NO. ~~ C>J r) of duly of corporate of cer) BUILDING PERMIT APPLICATION CHECKLIST on the tax roll or latest deed) I of cer 7wnt r Plumbers License No. _ Electricians License No._ Other Trade's License No. of land on w tch proposed work will be done: A,~~ tJ.~ LV~ House Number Hamlet County Tax Map No. 1000 Section f Q 6 Block~Lot ~y • `~ Subdivision SVhS27~ ~~5 Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition ~ Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars ' 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front_ Height Number of Sto Rear Depth Dimensions of same structure with alterations or additions: Front Height Number of Stories ,:. Dimensions of entire new construction: Front Rear ~~j~th . Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO!1 13. Will lot be re-graded? YES_ NO Will excess fill be removed from premises? YES_ NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? *YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? *YES NO~ * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) (Name of individual signing contract) above named. (S)He is the being duly sworn, deposes and says that (s)he is the applicant CONNIE D. BUNCH Notnry Public, S?ate of New York ~ No. Ot uU6185050 Officer, etc.) Commission ExplresApril 14, of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swo(r~n toybefore me th' Notary Public +/~ ignature of pphcant v', t n.. ..i r _ _ _ ~~ ~~ ~~ ~ !''fig OF SOUTI~OLD FRC~PERTY RECORD CARD - - )WNER - $TRfET y JS L VfL AGe: DIST. j SUB. LOT 3~-3~.~~~~~; Q J Y-~/ 1 ( ~~ I ~•I 5 ~~rr S~ ~Ct-° ~~_ .~. " / ~t~o1l`~~Jvc K .~,- ,-,--_ `~_~ L RA!1fR,~J~N€f~~ IP~~ i f ff~~ `j-( ~ N E AGR.~ I. ~~ 2 t S W TYPE OF BUfLDfNG {pFJ. ~.~- ` 'S. SEAR. VL. FARM COMA. CB. MICS. Mkt. YaEue ~ LAND IMP. 70TAL DATE REMARK r ! ( ~ '~ J ~ ~ I OD :f 6 r' r~ y ->~.- ~, - ,~ 5 .a ~~ ~ asp i3 i „ °/~.' .,-.,~ ;i,, (~ ~' '_d ^QQ ~~.!- s" ~ {Q ~' t'J ~7R J' E'~t_~~'t'.~3~'~ 6L y,Y ~1~'A~s~~l.-~ I ~~`_ ~ e 3 0.~ ~,) r' .r/i s jF~ 'i ' ~': .v.' t+ .- r~^ at~o~ ' t 7DD 6 00~~ DQ 8 ~3 ~ c~z' ~s ~' e {~au' `411 . -LIZ?1Z ~l5-~}~~l~i ; ~-a ~~'1~1~~ S ~G ~ ~ z ~ ~IiJiz-~-ate?~Z p~+~-Phli,~s~ ~%l~;tir~,s ~ jc _ abls ~ FRONTAGE ON WATER }~ ) ~~! 12-L~Z~1L ~~~-~1h11~1~I.S '~v l'I~{ISIS /+~1L- adla~ FRONTAGE ON ROAD ~dowlend DEPTH use Plot ! acve ~6~ i6o ra5 BULKHEAD ,2. e oo J SOS ;(~3 ~I .- --- ---- _== ~- cal_ol: ' = % ~ a u, TRIM G' > n .c= : 1 ,~ ~ e s , Y ~ I ~ i ~ ,~ _ I '" M. Bldg. r:.: r. ~, . ;: Fxtensian _ Extension 4 :, 4 ; Extension -_ • a Foundation `~' ~'• ~ ~' 8oth ~ Dinette laich a ~. ~ a G - Z _ . I .~.~ ~ 8osement f , i .. ,* ~ Ffoors _ ~ ~ K. ity*ck aC ' _ IJ ~ Ext. Wa!!s I`c v ' ` ' interior Finish Sl, ~ G f~ ~R, ~ 'i Breezeway I Fire Place I•ieat f DR. Garage _, ~ ~ r~ : ~? ~ \ yRe Roof Rooms 1st Floor BR• `3 I ~o ~ r ~ f f 1! ~ Z" .~ ~( ~ r i7 / , ~ (,~ Recreation Room Rooms 2rtd Floor FIl•!. B I O. E. Donner Driveway ~ --~ i ~ 7Qyol - 2 ~3 zsoo NU CC "7 3 ,~f3 ~ New York State Insurance Fund R'ockers' Compensation 8c Duabi/ity Benefits Specialists Since 1914 8 CORPORATE CENTER DR, 3RD FLR, MELVILLE, NEW VORK 117473129 Plane: (631)756<"i00 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^ ^ ^ ^ ^ ^ sooooos22 GRASS PLUS INC 1755 STANLEY ROAD PO BOX 748 MATTITUCK NY 11952 POLICYHOLDER CERTIFICATE HOLDER GRASS PLUS INC TOWN OF SOUTHOLD 1755 STANLEY ROAD MAIN ROAD PO BOX 748 SOUTHOLD NY 11971 ~~ MATTITUCK NY 11952 POiIO 5N3 M~Ba R CERTI 558 98 NUMBER I PERIOD040/22/201C3 TO 05/27/2o13TIFICATE 5/10/20E3 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1451 356-8 UNTIL 0527/2013, COVERING THE ENTIRE OBLIGATION OF THIS POUCYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 05/272013 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. ANDY KUPECKI, PRES OF GRASS PLUS INC (ONE PERSON CORP) THIS POLICY IS CANCELLED EFFECTIVE 05272013. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at hltps:!/www.nysif.comlcerUcertval.asp or by calling (888) 875-5790 VALIDATION NUMBER: 210738904 U-26.3 Suffolk County Department of Consumer Affairs VETERANS MEMORIAL HIGHWAI' * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 7/21/2011 No. 49051-H SUFFOLK COUNTY Home Improvement Contractor License This is to certify that ANDREAS J KUPECKI doing business as GRASS PLUS INC having furnished the requirements set forth in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York is hereby licensed to conduct business as a HOME IMPROVEMENT CONTRACTOR, in the County of Suffolk. License Category NOT VALID WITHOUT Additional Businesses Landscaping DEPARTMENTAL SEAL AND A CURRENT CONSUMER AFFAIRS ID CARD r!~~' et/~ure.' Dvector STANLEY N m N o. ~°'S ry •oo, M X103 O U o~ 2 -a oN O V y Q_ Z m .y,.;ii .~.f.• _. +Z3 p~+~Y 17 AN1 ll. 48 ~o~ 36 ~-- ~` I ZO 0~ ~,~~. '- "~~`l _ ~ lsr~ ~sz' / -' ~ e /~ /~ T~~ 1; ~~ t 7.°. ~`~~'.J 2^y..,i ~, ~` f?; -' `_~ ~~ Y .1 ~ ~i V a SUFFOLK COUNTY HEALTH DEPART. DATE MAY 17 1973 H. D. REF. $~ The sewage disposal and w?+er set facil7i'es for this location bout inspected by this dep tment and to be satisfactory Chief of Ge eral EnginE Services I a _ ~ ~ ~~e ss' ~ ~ m ~ M y +~ ~ C N ~ iv o .3 ~ cn ~" 0 0 o v N h J ~ ~ REV' ~ ~ MART. `~ MAR.2 f MAY I I 2~ 1 ,' y^^rw S 78°53 Lai 3B OIE iZGEN 135 IIBAG 11a 0 i lz S~~~Y 40 0 20 40 80 1 inch =40ft. GRAPHIC SCALE ( IN FEET ) (14621)- DENOTES FILED MAP LOT NUMBERS SURVEY NOTES: 1. UNAUTHORMEO ALTERgTION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION Tfi90F THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP XOT BEARING THE SURVEYOR'91NKf0 OR EMBOSSED SEAL SIULL NOi BE CONSIDERED TO BE A VALID TRUE COPT. LERTIFICATNINb INDICATED HEREON 9HgLL RUN ONLY TO THE PERSONIPERSONS FOR WHOM THE SURVEY IS PREPARED, AND ON HISIHERITHEIft BEHALF TO THE TFILE COMPANY, GOVERNMENTAL AGENCY. AHD LEHDIND INSTITUTION LISTED HEREON. CERTIFICATIONS ARE NOT TRANSFEfiABLE TO ADDITIONAL INSTITUTIONS OR SDBSEOIIENT OWNERS. 3. THIS SUflVEY 19 SUBJECT TO ANY EASEMENT OF RECORD AND OTHER PERTINENT FACTS WHICH AN ABSTRACT OF TITLE MIGHT DISCLOSE. J. OFFSETS SXOWH HEREON ARE FOR A SPECIFIC PURPOSE ANO SX W LD NOT BE USED AS A BASIS FOR CONSTRUCTION OF FENCES Ofl OTXEft STRUCTURES. 4. SUBSURFACE STRUCTURES ANOIOR UTILITIES, IF ANY. NOT SHOWN. 5. HEDGE ANO FENCE OFFSETS SHOWN ARE TO CENTERLINE UNLESS OTXERWISE NOTED. I CERTIFY TXgT THIS MAP REPRESENTS AN gCCURATE qND TRUE ACCOUNT OF q SURVEY, PERFORMED IN THE FIELD UNDER MY SUPERVISION ON MJMSOtJ, OF THE LAND iXEREIH PgRTICULARLY DESCRIBED. THE RECORD DESCRIPTION OF THE SUBJECT PROPERTY FORMS A MATHEMATICALLY CLOSED FIGURE. TXIS SURVEY Wq3 PREPARED IN gCCOROANCE WITH THE CURRENT CODE OF PMCTCE FOR LAND SURVEYORS ADOPTED BY THE NEW YORX STATE ASSOCIATION OF PROFESSIONAL IgHp SURVEYOft3. T. EASON LAND SUKVEYOK ~~~ sSOS NE.SCONSET H/G[iIGAY, SU17L z36; MT SINAI, NEIh YORK 71766 P/iaMe (631)474-2700 /Fnx (G31J 899-908s emnil TN.A,SOAIiS@OPl'ONLIN1i.N1iT I30UNDAKY SURVEY .SUI~VFYFOK• PETER PHILLIPS Mf1P OF.• SUNSET KNOLLS, SECTION 2 LOCATION: MATTITUCK, TOWN OF SOUTHOLD, NY CEKTIFIED TO: PETER PHILLIPS SUFFOLK COUNTY DLST. 1000 S'EC. 106 BLK 8 LOT 54.004 DATE: 4~30~13 I .SCALE: 1 "=40' PROjECTlulJzl'IHER~ TEA13-135 ~ ~ , _s. i.IC ~# osoasz ~0" ~ S 87°11'00" E 12.23'